RESUMO
One of the methods of non-drug treatment of essential arterial hypertension, is manual, osteopathic effects on the spine, primarily the cervical spine. Despite the absence of these methods in clinical guidelines for essential arterial hypertension, they continue to develop and improve. One of the promising areas is manual-physical correction with an effect on the cervical spine and subsequent strengthening of the muscle corset with the help of physical exercises (method of A.Yu. Shishonin). One of the supposed mechanisms for reducing blood pressure (BP) in this case is the effect on the autonomic nervous system (ANS). In the course of the study, which was based on the study of heart rate variability (HRV), the presence of pronounced signs of a decrease in sympathetic influences and activation of the parasympathetic nervous system was shown. The parameters of statistical linear analysis (standard deviation of NN intervals; stress index, etc.) and the wave spectrum shifted towards sympathicotonia during therapy using the method of A.Yu. Shishonin. The HRV data were obtained against the background of a decrease in blood pressure and a decrease in heart rate (HR), which suggests the impact of manual physical correction on the ANS as one of the key mechanisms mediating its effect.
Assuntos
Sistema Nervoso Autônomo , Frequência Cardíaca , Hipertensão , Humanos , Hipertensão/terapia , Hipertensão/fisiopatologia , Sistema Nervoso Autônomo/fisiopatologia , Masculino , Feminino , Frequência Cardíaca/fisiologia , Pessoa de Meia-Idade , Hipertensão Essencial/fisiopatologia , Hipertensão Essencial/terapia , Pressão Sanguínea/fisiologia , Adulto , Manipulações Musculoesqueléticas/métodosRESUMO
In the early 20th century, the term «selfish brain¼ appeared in scientific literature, around which theory was formed, finding its proof in the work of doctors and scientists. The basic principle of the theory is that the superior hierarchy of the brain, whose needs are prioritized, results in the primary satisfaction of one's own needs, often to the detriment of the functioning of other organs and systems. The origins of the theory of «selfish brain¼, according to researchers, lie in the work of neurosurgery pioneer Harvey Cushing, who discovered a reflex named after him and consisting in increasing arterial pressure at high intracranial pressure. Later, the field of action of this phenomenon was expanded by specialists who showed that an increase in arterial pressure can occur not only in critical situations and arise not only at high intracranial pressure, but also as a result of hypoxia of the brain. It was also found that the remodeling of intracranial vessels in hypertensive disease may be not only a consequence, but also a cause. Currently, similar patterns have been established in relation to other processes - exchange, immune and others. It was found that the priority of brain energy needs in different situations can affect insulin resistance and glucose tolerance. These effects can be realized through various mechanisms, but the advantage is through vegetative (autonomous) nervous system, mainly through sympathetic link, and also through simulation of the functioning of parasympathetic link. It is known that there is currently a rapidly increasing number of pathologies associated with degenerative-dystrophic processes of the spine, and other factors that disrupt the blood flow in the vertex-basilar zone of the Willis circle, Correction of these processes with the help of a set of manual techniques and physical methods (A. Yu. Shishonin's method with correction of aerobic-anaerobic energy balance in the reflex zones of the brain stem) Can have a good effect on the treatment of hypertensive disease and other chronic non-communicable diseases.
Assuntos
Encéfalo , Humanos , Encéfalo/fisiologiaRESUMO
There is a long-observed relationship between the pathology of the spine and arterial hypertension. There are a number of explanations for this, including one based on reflex effects and obstruction of blood flow to the cerebral vasodilatory centre localized in the rhomboid fossa projection. Obstruction can be absolute and relative, preventing the increase of blood flow during stress, when the brain turns on additional energy demand (phenomenon of «selfish brain¼). In conditions of insufficient blood supply anaerobic metabolism is included, requiring in the future, the addition of anaerobic glycolysis products. This leads to the persistence of an elevated level of AD and is part of the theory of centralized compensation of aerobic-anaerobic balance (theoretical aerobic-anaerobic energy concept, TAAEBC). The existing methods of manual manipulation and physical action on the spine, mainly the atlantoacral section of the cervical spine, have, according to existing publications, varying degrees of effectiveness. The modern approach to treatment of arterial hypertension and correction of metabolic disorders by A. Shishonin is promising. It is based on the TAAEBC concept and assumes a system approach and long-term effect through a consistent three-step manual and physical interventions aimed at restoring, retaining and long-term support of the vertebral blood flow.
Assuntos
Hipertensão , Manipulação da Coluna , Humanos , Manipulação da Coluna/métodos , Hipertensão/terapia , Hipertensão/fisiopatologiaRESUMO
There are some non-communicable diseases (NCD) associated with arterial hypertension (AHT) that are cured after recovery from AHT. Recently confirmed the theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC) originated some NCDs with the obstructions of arterial blood flow access to the rhomboid fossa. For some sergeants, this has already been demonstrated. Since neurological NCDs are similarly considered by TCAAEBC, it is logical to analyze dynamics of such musculoskeletal neurological problem as isolated musculoskeletal chest pain (IMCP) in connection with the therapy based on TCAAEBC. We retrospectively evaluated the medical records of adult patients with AHT, simultaneously suffering from IMCP. All these patients underwent complex treatment including manual techniques that restore arterial blood flow to the rhomboid fossa, followed by therapy that strengthens the muscular corset primarily of the cervical region. This, in addition to the normalization of AHT, led to a decrease in the musculoskeletal pain syndrome. The dynamic of pain was recorded according to four questionaries - Oswestry Disability Index (ODI) Hospital Anxiety and Depression Scale (HADS), Numerical Rating Scale (NRS), and the Quality-of-life assessment questionnaire (SF-12). The collected data were analyzed with the Wilcoxon signed-rank test, which confirms the recovery of the patients from both AHT and IMCP.
Assuntos
Hipertensão , Humanos , Hipertensão/terapia , Hipertensão/fisiopatologia , Hipertensão/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Doenças Musculoesqueléticas/terapia , Doenças Musculoesqueléticas/fisiopatologia , Doenças Musculoesqueléticas/psicologiaRESUMO
Cardiovascular diseases and diabetes mellitus, debuting as arterial hypertension (AH) syndrome and prediabetes, are common types of chronic non-communicable processes, that are the leading cause of death in the world. The main treatment method for above mentioned disorders, according to the current guidelines, is pharmacotherapy. However, it is possible to effectively apply non-pharmacological correction methods, aimed at the probable etiological factor and inversive mechanism involved in AH maintenance, in the early stages when no permanent changes are maintaining a high level of blood hypertension (BH) and glycemia. Frequently, this mechanism is hypoxia in the vertebral arteries system due to cervical spine osteochondrosis. OBJECTIVE: To evaluate the therapeutic effect of non-pharmacological methods of restoring brainstem blood supply in patients with AH and prediabetes. MATERIAL AND METHODS: The number of patients equal 125 (57 men and 68 women, mean age 63.3±11.5 and 65.4±11.8 y.o., respectively) with prediabetes and 1st degree of AH without target organs damage, among whom 102 patients with prehypertension or 1st degree of hypertension and 24 ones with 2nd degree of hypertension, were examined. The original method of manually restoring brainstem blood supply developed in the Shishonin's Clinic was applied to all patients. The control group included patients with the same disorder, who did not receive manipulations. Blood pressure (BP) measurement, ultrasound and triplex ultrasonography of vertebral arteries, biochemical blood test, and estimation of glycemia and glycated hemoglobin were performed. RESULTS: All patients of the study group had decreased levels of systolic BP (by 23.8±10.7 mm Hg for men and 32.8±11.9 mm Hg for women), an increase of flow velocity in vertebral arteries (by 20.6±7.5 and 21.5±7.2 cm/s, respectively), a decrease of glycated hemoglobin concentration (by 0.32±0.51 and 0.34±0.41%, respectively). In the comparison group, there were no patients with improvement in these indicators. CONCLUSION: The effectiveness of the author's manual method of cervical spine osteochondrosis correction in the reduction of BP and glycemia levels in the early stages of the disease is shown.
Assuntos
Hipertensão , Estado Pré-Diabético , Osteocondrose da Coluna Vertebral , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Hemoglobinas Glicadas , Hipertensão/complicações , Hipertensão/terapia , Pressão SanguíneaRESUMO
Several chronic non-communicable diseases are associated with arterial hypertension and are closely related to increased blood pressure. The theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC) was formulated in connection with the above-mentioned processes. This theory, including the hypothesis of the «egoistic brain¼, is a broader concept. The key point of TCAAEBC is hypoxic anaerobic metabolism, which affects reflex vascular zones, including the neurons of the respiratory and cardiovascular centers of the rhomboid fossa of the medulla oblongata. Hypoxia correction using manual techniques, physical exercises, and other non-pharmaceutical methods under certain conditions can stabilize the level of blood pressure and has a curative effect in the case of arterial hypertension syndrome.
Assuntos
Hipertensão , Humanos , Anaerobiose , Hipertensão/terapia , Pressão Sanguínea/fisiologia , Metabolismo Energético , HipóxiaRESUMO
The rehabilitation of patients after upper limb injuries is becoming increasingly relevant in current medical practice considering that this pathology is often occurred in professional athletes, elderly people, people with active lifestyle. OBJECTIVE: To study the effectiveness of isolated therapeutic exercises (TE) with eccentric muscle loads when using rubber cable compared to traditional TE to restore functional capabilities of patients after upper limb injuries. MATERIAL AND METHODS: The study included 38 patients with upper limb injuries diagnosed by orthopedic surgeon. Patients were randomly enrolled into group of isolated TE with eccentric muscle loads (group A, 20 patients, mean age 40.2±10.8 years) and group of traditional exercises (group B, 18 patients, mean age 38.6±12.3 years). The study consisted of anamnesis taking, clinical examination, functional tests applying (isometric dynamometry, joint mobility tests, functional scales and questionnaires). The rehabilitation effectiveness was assessed by comparing the indicators before and after treatment course. RESULTS: There has been a significant improvement in muscle strength, movement amplitude and decrease of pain syndrome in patients rehabilitated by eccentric muscle loads. A comparison with a control group using traditional TE methods confirmed the superiority of eccentric exercises in reducing recovery time and improving functional performance. CONCLUSION: The study confirmed the high effectiveness of eccentric muscular loads in the rehabilitation of patients after upper limb injuries. The method has shown significant improvement in clinical and functional indices, which allows to recommend it for inclusion in standard rehabilitation protocols. Further researches may extend application of this approach and reveal the TE effectiveness in other types of traumas and orthopedic injuries.
Assuntos
Extremidade Superior , Humanos , Adulto , Masculino , Feminino , Extremidade Superior/fisiopatologia , Extremidade Superior/lesões , Pessoa de Meia-Idade , Terapia por Exercício/métodos , Força Muscular/fisiologia , Traumatismos do Braço/reabilitação , Traumatismos do Braço/fisiopatologiaRESUMO
Arterial hypertension is a major risk factor for cardiovascular disease, affecting a large proportion of the population worldwide. The study of the listed literature made it possible to assess the effectiveness and necessity of physical exercise in the treatment of hypertension syndrome, including various types of exercise, intensity, duration, and frequency, since drug treatment is not enough for successful therapy. To prevent and treat hypertension, a comprehensive approach is required, including aerobic exercise, which will lower blood pressure by dilating blood vessels.